An Episcopal (Anglican) Chaplain in the Saint Luke's Health System of Kansas City, reflecting on work and faith and life. NOTA BENE: my opinions are my own and do not represent the Episcopal Church or the Saint Luke's Health System.

Wednesday, December 12, 2012

What Was the Cause of the Stomach Upset?

Last week my
Best Beloved pointed me to this article in the New York Times on line. The topic is a
new research study that takes a close look at one of the most common medicine
regimens in use: taking low dose aspirin to prevent clots that might lead to
heart attack or stroke.

The article
highlights several questions about aspirin therapy that have come up over the
years. There’s general agreement that a lot of folks benefit from taking low
dose aspirin. On the other hand, aspirin, even at low doses, has some risk of
irritating the stomach lining and causing some bleeding. So, does an enteric
coating – a coating that delays the digestion and absorption of the aspirin –
spare the stomach and prevent the bleeding? On the other hand, does it
interfere with absorption so that the benefit isn’t as great? There has been a
theory, too, that some people don’t benefit at all from the aspirin because of
“aspirin resistance.” So, is that a real problem? Or does perhaps the enteric
coating prevent the absorption, creating the symptoms of “aspirin resistance?”

This is a news
article. While it provides a good general description of the clinical
questions, it doesn’t go into detail. I’m sure that articles written for more
clinical audiences will address the scientific questions in more detail.

However, what
I really do like about this article is how well it highlights the various
conflicting interests. Read it at all carefully, and you’ll see the questions
the reporter raises about the relationships between research funding and
research results. There are legitimate questions, really. I believe that the
researchers want to benefit patients. I believe they look at their research
results and interpretations, and are honest. At the same time, it’s also clear
that there are commercial supporters for each position, prepared to fund
further research that will help seem to argue for their products. And while
correlation is not causation, those connections between research funding and
research results are as worthy of study as the medications themselves.

So take a few
minutes with this article. It’s hardly definitive. There will need to be more
research to justify any of these clinical positions. But it shines a light on
the interconnections between research, researchers, and funders – connections that
are arguably troubling.